Individual
JANA GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
801 MOBLEY ST, JOHNSTON, SC 29832-1366
(803) 275-4653
(803) 275-1951
Mailing address
801 MOBLEY ST, JOHNSTON, SC 29832-1366
(803) 275-4653
(803) 275-1951
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F579
SC
Other
Enumeration date
06/17/2006
Last updated
07/08/2007
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